Laserfiche WebLink
DAT IV [1 ,1 ^3.J�: <br /> }=` y. ` ""-� SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> .JUL 5 7013 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Te�e( hone:(209)468=3420 Fax:(209)-464=0138 Web: wwws�gov.orgrhd <br /> GNLf' YA;@f tc.-iLEf <br /> P'Uri'•:i!i�ie�:�iL,��t) � <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: l�r(SIn C/N,�2iBUSINESS/AGENCY: F-� 12 Zv1 <br /> ADDRESS: b� S r'F S� c C q ¢� CITY/STATE/ZIP: Sa,,,, Qr (�f Q,4ggqoJ <br /> PHONE (1) ( 046 -�Z 5 PHONE (2): FACSIMILE.- <br /> TE TATIVE"APPOINTMENTDATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> [] CHECK BOX TO EXPEDITE RE T- 125 FEE(CA C ECK Y)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT C DATE C75 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> 11 Street# Street Name City ❑ Unit 1 <br /> .apt,-� g e w�av� Z L i 1 /yi ,No cols <br /> V . 2. So,, t2 L�d I mImEw - �t <br /> 3. f1 <br /> 4. 2fUnit3 <br /> 5. <br /> 5' Unit4 <br /> 7. ' <br /> 8. <br /> ❑ Unit <br /> 9. <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> [� DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑S LID WASTE FACILITYIVE/HICLE <br /> r[�HER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE J�j✓I�3 JfJ�( ( {3- <br /> L_,U UNDERGROUND TANK(MONITORINGIREMOVAL� ❑FOOD FACILITY ❑DAIRY l_6 <br /> �OVEGROUND TANK l7` ❑CHICKEN RANCH/DOG KENNEL [WASTEWATER TREATMENT PLANT <br /> AZARDOUS WASTEIHAZARDOUS MATERIALS ' ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> .3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. "'BOXED AREA-EHD USE ONLY"` <br /> 16 17i • ► t &1A FI <br /> 8'f e <br /> b' is 50 & 1 uN <br /> - no 3314th - - ID12 <br /> ❑ Records provided by Staff-PPR Complete. taff Name: <br /> EHD 46-D6 <br /> 9/4112 <br />